RESUMEN
INTRODUCTION: A principal cause of death following presumed recovery from an episode of shock is the development of shockogenic trauma [post-resuscitation syndrome]. The causes of this complication remain unclear and its various treatments continue to be controversial. HYPOTHESIS: The use of perfusion of the blood of patients suffering shockogenic trauma through a donor pig spleen will decrease the mortality from the complications of this process. METHODS: Freshly harvested pig spleens were adjoined to the venous circulation of patients suffering severe shockogenic trauma and the patient's blood perfused through them for periods of 30-60 minutes. The mortality rates of similar patients treated in this manner were compared with those not treated. Blood analyses included measures of the functions of the renal, immune, and coagulation systems. RESULTS: The experience with 212 Extracorporeal Joinings of Donor (pig) Spleens (EJDS) by means of a veno-venous shunt for the treatment of 86 patients with severe shock trauma and its complications is reported. The clinical effects consisted of decreasing signs of intoxication, namely reduction in fever and in the severity of associated encephalopathy. Extracorporeal joinings on donor (pig) spleens (EJDS) was followed by a decline in the concentration of "middle molecules," fibrinogen levels, leucocyte intoxication index, and the number of circulating immune complexes at different times following completion of the procedure. The number of blood cells remained constant. On the following day, there occurred an increase in the number of thrombocytes. In addition, there was a decline in the quantity of circulating particles in the plasma.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Circulación Extracorporea/mortalidad , Bazo/irrigación sanguínea , Animales , Humanos , Bazo/inmunología , Bazo/cirugía , PorcinosRESUMEN
On 35 heparinized cats with experimental traumatic shock induced according to Cannon, changes in the coronary blood flow, produced by intravenous injections of noradrenaline, angiotensin, hydrocortisone, histamine, and serotonin, were studied. Traumatic shock was characterized by decreases in the coronary blood flow and organic oxygen uptake, despite a simultaneous decrease in the regional vascular resistance. Injections of noradrenaline (14-18 mug/kg) and angiotensin (29 mug/kg) induced, both in the initial normal state and in shock, increases in the coronary blood flow rate and in the regional oxygen uptake; an injection of hydrocortisone (7.1 mg/ml) produced similar effects in the normal state, but did not elevate the oxygen uptake in shock; an injection of histamine (32 mug/kg) had no effect on the coronary blood flow rate, but reduced the regional oxygen uptake both in the normal state and in shock; an injection of serotonin (30 mug/kg) exerted no major effects on the blood flow. The results obtained might serve as guidelines for pharmacological regulation of coronary circulation in shock.